Literature DB >> 21569483

Diagnostic scope in out-of-hours primary care services in eight European countries: an observational study.

Linda A M J Huibers1, Grete Moth, Gunnar T Bondevik, Janko Kersnik, Carola A Huber, Morten B Christensen, Rüdiger Leutgeb, Armando M Casado, Roy Remmen, Michel Wensing.   

Abstract

BACKGROUND: In previous years, out- of-hours primary care has been organised in large-scale organisations in many countries. This may have lowered the threshold for many patients to present health problems at nights and during the weekend. Comparisons of out-of-hours care between countries require internationally comparable figures on symptoms and diagnoses, which were not available. This study aimed to describe the symptoms and diagnoses in out-of-hours primary care services in regions in eight European countries.
METHODS: We conducted a retrospective observational study based on medical records from out-of-hours primary care services in Belgium, Denmark, Germany, the Netherlands, Norway, Slovenia, Spain, and Switzerland. We aimed to include data on 1000 initial contacts from up to three organisations per country. Excluded were contacts with an administrative reason. The International Classification for Primary Care (ICPC) was used to categorise symptoms and diagnoses. In two countries (Slovenia and Spain) ICD10 codes were translated into ICPC codes.
RESULTS: The age distribution of patients showed a high consistency across countries, while the percentage of males varied from 33.7% to 48.3%. The ICPC categories that were used most frequently concerned: chapter A 'general and unspecified symptoms' (mean 13.2%), chapter R 'respiratory' (mean 20.4%), chapter L 'musculoskeletal' (mean 15.0%), chapter S 'skin' (mean 12.5%), and chapter D 'digestive' (mean 11.6%). So, relatively high numbers of patients presenting with infectious diseases or acute pain related syndromes. This was largely consistent across age groups, but in some age groups chapter H ('ear problems'), chapter L ('musculoskeletal') and chapter K ('cardiovascular') were frequently used. Acute life-threatening problems had a low incidence.
CONCLUSIONS: This international study suggested a highly similar diagnostic scope in out-of-hours primary care services. The incidence rates of acute life-threatening health problems were low in all countries.

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Year:  2011        PMID: 21569483      PMCID: PMC3114765          DOI: 10.1186/1471-2296-12-30

Source DB:  PubMed          Journal:  BMC Fam Pract        ISSN: 1471-2296            Impact factor:   2.497


  21 in total

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Journal:  Fam Pract       Date:  2000-08       Impact factor: 2.267

2.  Out of hours service in Denmark: evaluation five years after reform.

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Journal:  Fam Pract       Date:  1997-12       Impact factor: 2.267

6.  Outpatient antibiotic use in Europe and association with resistance: a cross-national database study.

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7.  Out-of-hours service in Denmark: the effect of a structural change.

Authors:  B L Hansen; A Munck
Journal:  Br J Gen Pract       Date:  1998-08       Impact factor: 5.386

8.  What's the effect of the implementation of general practitioner cooperatives on caseload? Prospective intervention study on primary and secondary care.

Authors:  Hilde Philips; Roy Remmen; Paul Van Royen; Marc Teblick; Leo Geudens; Marc Bronckaers; Herman Meeuwis
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9.  Management of lower urinary tract infection in women by Slovene GPs.

Authors:  Josip Car; Igor Svab; Janko Kersnik; Miljana Vegnuti
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10.  Out of hours service: the Danish solution examined.

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  40 in total

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3.  [Costs-revenue deficit of outpatient treatment of minor injuries in the emergency department].

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5.  Increase in antibiotic prescriptions in out-of-hours primary care in contrast to in-hours primary care prescriptions: service evaluation in a population of 600 000 patients.

Authors:  G N Hayward; R F R Fisher; G T Spence; D S Lasserson
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6.  To what extent does sociodemographic composition of the neighbourhood explain regional differences in demand of primary out-of-hours care: a multilevel study.

Authors:  Tessa Jansen; Marieke Zwaanswijk; Karin Hek; Dinny de Bakker
Journal:  BMC Fam Pract       Date:  2015-05-06       Impact factor: 2.497

7.  Workload and management of childhood fever at general practice out-of-hours care: an observational cohort study.

Authors:  Eefje G P M de Bont; Julie M M Lepot; Dagmar A S Hendrix; Nicole Loonen; Yvonne Guldemond-Hecker; Geert-Jan Dinant; Jochen W L Cals
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8.  Antibiotic prescribing patterns in out-of-hours primary care: a population-based descriptive study.

Authors:  Linda Huibers; Grete Moth; Morten Bondo Christensen; Peter Vedsted
Journal:  Scand J Prim Health Care       Date:  2014-10-28       Impact factor: 2.581

9.  Factors associated with the utilization of primary care emergency centers in a Spanish region with high population dispersion: a mixed-methods study.

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10.  From Doctor to Nurse Triage in the Danish Out-of-Hours Primary Care Service: Simulated Effects on Costs.

Authors:  Grete Moth; Linda Huibers; Peter Vedsted
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